Donald Triplett, ‘Case 1’ in the study of autism, dies at age 89

Donald Triplett, who was “Case 1” in the history of autism diagnosis as a child and became an influential case study in how people with autism can find fulfillment as an adult, died Thursday at his home in Forest, a small town in the center of Mississippi. He turned 89.

The cause was cancer, said his cousin, OB Triplett.

The prevalence of autism diagnosis has been rising for decades. In 2006 about one in 110 children had the condition. In March, it was one in 36, according to the Centers for Disease Control and Prevention.

What caused this rise is a matter of debate. What is clear is that modern understanding of autism can be traced to events in Mr. Triplett’s childhood.

Donald Gray Triplett was born in Forest on September 8, 1933, to Mary (McCravey) Triplett, a high school English teacher whose family owned the local bank, and Beamon Triplett, a lawyer trained at Yale Law School .

Don seemed to live in a world separated from his family and the rest of society. He didn’t respond to other children, to a man dressed as Santa Claus, not even to his mother’s smile.

He used language in a way that suggested personal meanings, inexplicably assigning numbers to the people he met and repeating mysterious phrases like “I could put a little comma or semicolon” and “shine through the dark cloud”.

He had a mania for other repetitive behaviors, including revolving objects such as cooking pots. If any of his various rituals were interrupted, he would throw destructive tantrums.

He had skills that were equally mind-boggling to those around him. He could answer the result of multiplying 87 by 23 without hesitation. He could sing songs with perfect pitch after only hearing them once. He was rumored to have calculated the number of bricks in his high school’s facade just by looking at it.

In August 1937, Don’s parents sent him to a state-run children’s home in Sanatorium, a Mississippi town. They met only twice a month and Don reportedly passed his days listlessly, even motionless at times.

At that time, it was common for children with serious mental health problems to be permanently institutionalized. But after about a year, Don’s parents insisted that they wanted him to return home. They soon took him to a doctor in Baltimore named Leo Kanner.

Dr. Kanner had established the first child psychiatry clinic in the United States at Johns Hopkins University. At first he didn’t know how to describe Don’s condition.

Dr. Kanner, a Galician immigrant who had studied in Berlin, is said to have been familiar with the concept of “autism” developed by the Swiss psychiatrist Eugen Bleuler, who used it in the years before the First World War as a term for the total self-righteousness of some schizophrenic patients.

In a 1943 paper titled “Autistic Disorders of Affective Contact,” Dr. Kanner case studies of 11 children that, he said, illustrated a condition “markedly and uniquely different from anything reported to date” in the annals of psychology.

With Don as the inaugural case – he is referred to as “Case 1” and “Donald T”. — dr. Kanner outlined a disorder that included obsessive repetitive habits, an “excellent memory,” and an inability to interact with other people “in the usual way.” He called this form of autism “rare” but added that it is “probably more common than indicated by the lack of observed cases.”

That paper – along with extensive notes taken by Beamon Triplett describing his son’s condition to Dr. Kanner – became the basis of what is known today as autism spectrum disorder. The official description by the CDC and in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders is still reminiscent of Dr. Kanner.

As he got older, Donald Triplett never stopped having obsessions, talking mechanically, and struggling to hold a conversation. But his life also took a trajectory that seemed unimaginable when he was an institutionalized 4-year-old.

He graduated not only from high school, but also, in 1958, from Millsaps College, where he joined the Lambda Chi Alpha fraternity and studied French and math.

Skills he lacked as a teenager he picked up in his twenties and thirties. This is how he learned to drive and drove around in his own Cadillac. He took a job as a bookkeeper at the local bank co-founded by his grandfather, the Bank of Forest. With the help of a travel agency in Jackson, Miss., he managed to vacation on his own to countries around the world.

His remarkable self-reliance became a national story thanks to journalists John Donvan and Caren Zucker article about Mr. Triplett’s life for The Atlantic in 2010. That article led to a book, “In a Different Key: The Story of Autism”, which contains a finalist for the 2017 Pulitzer Prize in non-fiction in general, and a documentary of the same title that broadcast on PBS last year.

Mr. Donovan and Ms. Zucker drew several conclusions from Mr. Triplett’s story, including that his family’s wealth and social standing had been crucial in helping him live a decent life. But they particularly emphasized the importance of Mr Triplett’s birthplace and its approximately 3,000 inhabitants.

The community of Forest, they wrote for the BBC’s magazine in 2016, “made a probably unconscious but clear decision about how they were going to treat this strange boy, then man, who lived between them.”

“They decided, in short, to accept him,” they wrote.

Mr Triplett stayed close to his brother, Oliver, who facilitated his interactions with journalists. He died in 2020. Mr. Triplett had no direct survivors.

But he did have many friends. Some of them, a group of men, joined Mr. Triplett outside Forest Town Hall for coffee each morning. Neighbors decades his junior welcomed him to their team for the Forest Country Club golf tournament – and he played respectfully. People spoke of his skills in music and mathematics with admiration, so much so that they exaggerated how much of a scholar he was.

Three times during their coverage in The Atlantic, Donovan and Ms. Zucker wrote that Forest residents gave them a warning in strikingly similar language: “If what you’re doing hurts Don, I know where to find you.”

A friend of his put it this way: “Don has some strange behavior and some eccentricities, but he’s our guy.”